The Popularity of BOTOX®: Charlotte’s Dr. Adam Augenstein Notes Its Rise

While patients continue to choose plastic surgery when they want to make a cosmetic change to their faces, a particularly notable trend is the increasing popularity of nonsurgical options, such as BOTOX®. Charlotte’s Dr. Adam Augenstein noted with interest that the most recent statistics available from the American Society of Plastic Surgeons revealed a three percent increase in the use of cosmetic minimally invasive procedures as a whole across the United States from 2015 to 2016.

While treatments from chemical peels to soft-tissue fillers saw a jump in application, the clear favorite was a category titled “botulinum toxin Type A,” made up of injectables that temporarily relax muscles to reduce the appearance of related wrinkles and lines. This group includes Dysport®, Xeomin®, and the global leader: BOTOX® Cosmetic.

With BOTOX® contributing the vast bulk of that category’s success, the number of treatments performed in this country, according to the survey, leapt from 6,757,198 in 2015 to 7,056,255 in 2016. That’s a rise of four percent, comprising just shy of 300,000 people.

While the FDA has approved BOTOX® for various cosmetic uses since the early 2000s—and numerous medical uses in the decades prior to that—it is still gaining attention and notoriety. TIME wrote a cover story on the popular injectable earlier in 2017, highlighting the many uses for BOTOX® that have developed over the years and noting multiple potential new uses. Current studies, for instance, are exploring whether BOTOX® can play a role in helping curb the symptoms of depression in people.

The ASPS survey focused solely on cosmetic uses of BOTOX® and its fellow botulinum-based brethren. Perhaps not surprisingly, while the increase in these treatments performed from 2015 to 2016 was relatively modest, growth since the year 2000 was a formidable 797 percent.

Among the other details noted in the 2016 report:

• Women were the clear leader, over men, in terms of choosing BOTOX® and similar injectables, making up 6,608,747 of the total number

• There were 20,676 injection sessions performed on patients in 13-19 age range, 105,886 in the 20-29 range, 1,275,146 in the 30-39 range, 4,051,194 in the 40-54 range, and 1,603,353 in the 55-and-older range.

• The ASPS breaks the United States into five regions. Region 5 (Mountain and Pacific states) saw the most injections at 2,028,036. Next came Region 3 (South Atlantic, including North Carolina where Dr. Augenstein practices) with 1,667,360. Then Region 1 (New England and Middle Atlantic) with 1,419,286, Region 4 (East and West South Central) with 1,001,908, and Region 2 (East and West North Central) with 939,665.

BOTOX® is approved by the FDA specifically to reduce the appearance of frown lines on the forehead and crow’s feet. That said, many doctors also use it for what are known as “off label” uses, which are common and perhaps even well studied and established—but not officially endorsed by the Food and Drug Administration.

The cosmetic works by preventing contraction-causing signals from reaching their intended muscles. If these muscles remain still, they refrain from pulling the skin above, which reduces the appearance of lines that grow increasingly pronounced over time. These wrinkles are known as “dynamic wrinkles” because they form due to repetitive motion.

The ASPS compiles its annual report examining trends in cosmetic procedures and treatments by distributing surveys to member physicians and combining results with information from a national plastic surgery database, after which the numbers are aggregated and extrapolated.